Association between Maternal Postpartum Vitamin A Supplementation and Child Vitamin A Vaccination Coverage in Pakistan: Evidence from the PDHS 2017–18
Association between Maternal Postpartum Vitamin A Supplementation and Child Vitamin A Vaccination
DOI:
https://doi.org/10.54393/df.v6i4.195Keywords:
Vitamin A Supplementation, Child Immunization, Postnatal Care, Maternal-Child Health, PDHSAbstract
Maternal postpartum vitamin A supplement is a necessary intervention for maternal and child health. It has not been properly investigated regarding its impact on the Pakistani child vaccination coverage of vitamin A. Objectives: To evaluate the maternal postpartum vitamin A supplementation and child vitamin A vaccination coverage, that is, first-dose, second-dose, and full two-dose coverage. Methods: A survey was carried out among 200 mother-child pairs. Information on the maternal postpartum vitamin A supplementation and the child's vitamin A vaccination status was available. Associations and the effect size were assessed on descriptive statistics, Spearman correlation, and ordinal and binary logistic regression. Results: There was a strong correlation between the child vaccination and the presence of maternal postpartum vitamin A supplementation. The children of supplemented mothers were much more likely to take 100% of vitamin A (100% vs. 51.3; OR = 84.39, p=0.001) and 25.9% vs. 0.8% coverage (OR = 41.30, p=0.001). The second dose effect was less but significant (odds ratio, OR = 2.64, p=0.004). In Spearman correlation, there was a strong positive correlation with the first dose (r = 0.733, p=0.001) and a weak positive correlation with the second dose (r =.204, p=0.004). Conclusions: Maternal postpartum vaccination with vitamin A is a key factor that determines child vaccination with vitamin A, especially the first dose. In Pakistan, continuity of postnatal care, the combination of supplementation with routine immunization, and better caregiver counseling are needed to realize full vaccination and the best preventive health care outcomes of children.
References
1. Janmohamed A, Klemm RD, Doledec D. Determinants of Successful Vitamin A Supplementation Coverage Among Children Aged 6–59 Months in Thirteen Sub-Saharan African Countries. Public Health Nutrition. 2017 Aug;(11): 2016-22. doi: 10.1017/S1368980017000684.
2. Khan T, Malik S, Rafeekh L, Halder S, Desai S, Das Bhattacharya S. Facilitators and Barriers to Maternal Immunization and Strategies to Improve Uptake in Low-Income and Lower-Middle Income Countries: A Systematic Review. Human Vaccines and Immunotherapeutics. 2024 Dec; 20(1): 2411823.
3. Tessema ZT, Yazachew L, Tesema GA, Teshale AB. Determinants of Postnatal Care Utilization in Sub-Saharan Africa: A Meta and Multilevel Analysis of Data From 36 Sub-Saharan Countries. Italian Journal of Pediatrics. 2020 Nov; 46(1): 175. doi: 10.1186/s13052-020-00944-y.
4. Damerow SM, Zalisz AM, Nehal KR, Silva PM, Furtado O, Fisker AB. Identification of Gaps in the Continuum of Maternal and Neonatal Care in a High‐Mortality Setting: An Observational Study in Rural Guinea‐Bissau. Tropical Medicine and International Health. 2025 Jun 9.doi: 10.1111/tmi.14136
5. Owili PO, Muga MA, Chou YJ, Hsu YH, Huang N et al. Associations in the continuum of care for maternal, newborn and child health: a population-based study of 12 sub-Saharan Africa countries. BioMed Central Public Health. 2016 May; 16(1): 414. doi: 10.1186/s12889-016-3075-0.
6. Shahid M, Ali Z, Khan S, Yousaf MS, Zhang Z, Song J. Exploring the Potential Causal Relationship Between Health Insurance Coverage and Child Nutritional Status in Pakistan: Evidence From PDHS-2018. In Healthcare 2025 Feb 28 (Vol. 13, No. 5, P. 532). doi: 10.3390/healthcare13050532
7. Siddiqa M, Zubair A, Kamal A, Ijaz M, Abushal T. Prevalence and Associated Factors of Stunting, Wasting and Underweight of Children Below Five Using Quintile Regression Analysis (PDHS 2017–2018). Scientific Reports. 2022 Nov; 12(1): 20326.doi: 10.1038/s41598-022-24063-2
8. Abukari AS, Gaddah R, Ayivor EV, Haruna IS, Korsah EK. Assessing Postnatal Immunisation Services in a Low-Resource Setting: A Cross-Sectional Survey. In healthcare 2025 Jun(Vol. 13, No. 12, P. 1389). MDPI.doi: 10.3390/healthcare13121389
9. Alfaqeeh M, Suwantika AA, Postma MJ, Nugrahani AD, Setyani RA, Zakiyah N. Maternal Perspectives on Multiple Micronutrient Supplementation (MMS) In Indonesia: A Cross-Sectional Study of Knowledge, Attitudes, and Acceptance. Biomed Central Public Health. 2025 Dec; 25(1): 4062.doi: 10.1186/s12889-025-24885-5
10. Shah MP, Morgan CJ, Beeson JG, Peach E, Davis J, McPake B, Wallace AS. Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low-And Middle-Income Countries: Systematic Review Update 2011–2020. Vaccines. 2024 Nov; 12(12): 1313. doi: 10.3390/vaccines12121313.
11. Oliveira AV, Machado HR, Thomé Ú, Santos MV, de Angelis G, Leite JP, et al. Impact of epilepsy surgery on The Adaptive Behavior of Children with Drug‐Resistant Epilepsy. Epilepsia. 2025 Apr 29.doi: 10.1111/epi.18437
12. Richards‐Belle A, Linton D, Cross JH, Heyman I, Dalrymple E, Chorpita B, et al. Sudden Gains in Modular CBT For Mental Health Disorders in Children and Young People with Epilepsy. Journal of Child Psychology and Psychiatry. 2025 Mar. doi: 10.1111/jcpp.14164
13. Richards‐Belle A, Linton D, Cross JH, Heyman I, Dalrymple E, Chorpita B, Varadkar S, Shah M, MICE Study Group, Byford S, Coughtrey A. Sudden gains in modular CBT for mental health disorders in children and young people with epilepsy. Journal of Child Psychology and Psychiatry. 2025 Mar 20.
14. Wondie WT, Zemariam AB, Gedefaw GD, Lakew G, Getachew E, Mengistie BA et al. Vitamin A Supplementation Coverage and Its Associated Factors Among Children 6–59 Months of Age in Ethiopia: A Systematic Review and Meta-Analysis. Frontiers In Public Health. 2025 Apr; 13: 1496931. doi: 10.3389/fpubh.2025.1496931.
15. Carbone E, Smith S, Laar A, Akparibo R. Maternal Health Literacy and Empowerment in the United States: A Scoping Review. Medical Research Archives. 2024 Dec; 12(12). doi: 10.18103/mra.v12i12.6182.
16. Diyaolu CO. Advancing Maternal, Child, And Mental Health Equity: A Community-Driven Model for Reducing Health Disparities and Strengthening Public Health Resilience in Underserved US Communities. World J Adv Res Rev. 2025; 26(03): 494-515.doi: 10.30574/wjarr.2025.26.3.2264
17. Balogun OO, Aoki A, Tomo CK, Mochida K, Fukushima S, Mikami M et al. Effectiveness of the Maternal and Child Health Handbook for Improving Continuum of Care and Other Maternal and Child Health Indicators: A Cluster Randomized Controlled Trial in Angola. Journal of Global Health. 2023 Feb; 13: 04022. doi: 10.7189/jogh.13.04022.
18. Policy E. Assessing Inequality of Opportunities to Child Health and Nutrition: Comparison of Bangladesh and Pakistan. International Journal of Child Care and Education Policy. 2024; 7. doi: 10.1186/s40723-024-00133-y.
19. Habib I, Haq ZU, Imtiaz A, Khan MN, Afaq S, Fazid S et al. Maternal Dietary Diversity in Pakistan: Influences of Education, Poverty, And Food Insecurity from a Cross-Sectional Survey: Maternal Dietary Diversity: Influences of Education, Poverty, And Food Insecurity. Pakistan Journal of Health Sciences. 2025 Oct: 84-91. doi: 10.54393/pjhs.v6i10.3519.
20. Ali A. Current Status of Malnutrition and Stunting in Pakistani Children: What Needs to Be Done? Journal of the American College of Nutrition. 2021 Feb; 40(2): 180-92. doi: 10.1080/07315724.2020.1750504.
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